Citation Nr: A24020122 Decision Date: 04/22/24 Archive Date: 04/22/24 DOCKET NO. 201109-118632 DATE: April 22, 2024 ORDER Entitlement to a disability rating in excess of 70 percent for posttraumatic stress disorder (PTSD) is denied. FINDING OF FACT For the period on appeal, the Veteran's PTSD was manifested by symptomatology resulting in occupational and social impairment with deficiencies in most areas, without more severe manifestations that more nearly approximate total occupational and social impairment. CONCLUSION OF LAW The criteria for a disability rating in excess of 70 percent for PTSD are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.126, 4.130, Diagnostic Code (DC) 9411. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Marine Corps from November 12, 1986, to May 1, 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2020 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) that granted an increased rating for PTSD from 30 percent to 50 percent. In his Board Appeal (VA Form 10182) that was received by VA on November 9, 2020, the Veteran elected the Direct Review option. As the Veteran has selected the Direct Review Docket, the Board may only consider the evidence of record before the Agency of Original Jurisdiction (AOJ) at the time of its decision on the issue on appeal, namely the February 2020 rating decision. See 38 C.F.R. §§ 20.300(a), 20.301. Evidence has been submitted into the Veteran's file after the February 2020 rating decision and, as a result, it cannot be considered in this decision. Additionally, another rating decision was issued in February 2021, and which awarded the Veteran a rating of 70 percent for PTSD, effective January 15, 2019. As a result, the Board will limit its discussion to whether the Veteran is entitled to a disability rating in excess of 70 percent based on the evidence of record at the time of the February 2020 rating decision. 38 C.F.R. § 20.300. The Veteran may file a Supplemental Claim and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. Entitlement to an increased disability rating in excess of 70 percent for PTSD The Veteran asserts that he is entitled to a higher rating for his PTSD. In his VA Form 10182 that was received by VA on November 9, 2020, the Veteran asserted that he was entitled to a higher rating as he said his PTSD was worse than rated as it took a toll on his first marriage, and that he was living with anxiety and debilitating panic attacks. Here, there is only one piece of evidence that was obtained in the appeal period and that is a February 2020 VA PTSD examination and in it the examiner reviewed the record and determined that the Veteran had occupational and social impairment with reduced reliability and productivity. Further, the examiner noted that the Veteran was married (second marriage) and was in touch with his children and granddaughter and was currently employed as a loan reviewer and he had been doing so for 2.5 years. It was noted that the Veteran was on medication for his PTSD and that his symptoms included depressed mood, anxiety, panic attacks weekly or less, sleep impairment, flattened effect, disturbances in motivation and mood, and difficulty in adapting to stressful circumstances, including work or a work like setting. The examiner also noted that the Veteran: had sleep issues and was diagnosed with apnea, had passive suicidal thoughts (but none currently), had good short-term memory and that there was no compromise as to insight or judgment. Under the General Formula for Mental Disorders (General Formula), the Board must conduct a "holistic analysis" that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013). A 70 percent rating is assigned when symptoms such as suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); or inability to establish and maintain effective relationships cause occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. A 100 percent rating is assigned for total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; or memory loss for names of close relatives, own occupation or own name. The above-mentioned evidence supports the conclusion that the Veteran's service-connected PTSD does not warrant a 100 percent rating. Specifically, the evidence shows that the Veteran has not displayed symptoms listed or analogous to the criteria for a 100 percent rating under the General Rating Formula for Mental Disorders recounted above. There is no evidence submitted during the evidentiary period showing total social and occupational impairment due to the service-connected PTSD as to warrant the assignment of a schedular 100 percent rating evaluation at any time during the period of this appeal. Sellers v. Principi, 372 F.3d 1318 (Fed. Cir. 2004). Instead, the reflects that the Veteran is and has been working as a loan reviewer for 2.5 years and that he is currently married, living with wife and his children, and that he keeps in contact with his daughter from his first marriage, as well as his granddaughter. See February 2020 VA PTSD examination. The Board places great weight on the Veteran's actual, continued employment and his family relationships. The Veteran's passive suicidal ideation is a serious symptom of his PTSD, but that it is adequately accounted for, and explicitly listed, as a symptom in the criteria for the currently assigned 70 percent rating. See 38 C.F.R. § 4.130, DC 9411. Further, while the Veteran expressed passive suicidal ideation, which is similar to persistent danger of self-harm and is contemplated by the 100 percent criteria, the severity, frequency, and duration of the Veteran's passive suicidal ideation came and went and was not present at the time of the February 2020 VA PTSD examination, and, as a result, the Board finds it does not rise to the level contemplated by the 100 percent disability rating criteria. Essentially, all of the Veteran's symptoms mentioned are contemplated in the criteria for a 70 percent rating or less. Id.; See February 2020 VA PTSD examination. In sum, the Board finds that the evidence of record demonstrates persuasively that the Veteran does not have total occupational and social impairment due to his PTSD particularly in light of his continued employment and his familial (Continued on the next page) relationships. The Board concludes the criteria for a 100 percent disability rating are not met. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7. J. B. FREEMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Imber The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.